• 2 Guided Examples with the New CPT Codes for PT and OT Evaluations Image

    articleDec 5, 2016 | 8 min. read

    2 Guided Examples with the New CPT Codes for PT and OT Evaluations

    French poetry and comic-book lore have taught us that “with great power comes great responsibility.” And with the imminent rollout of of new CPT codes for therapy evaluations and re-evaluations, rehab therapists would be wise to take that message to heart. That’s because, on January 1, 2017, PTs and OTs will have even more power in the way of accurately representing the patients they treat and the services they provide. Case in point: they’ll scrap all four …

  • The Ins and Outs of the So-Called Pseudo-Codes Image

    articleNov 29, 2016 | 6 min. read

    The Ins and Outs of the So-Called Pseudo-Codes

    At some point or another, almost every rehab therapist has commiserated with a colleague over the billing process. We know; it’s one of your least-favorite parts of the job. But, while it’s certainly less fulfilling than providing patient treatment, accurately reporting CPT codes is imperative to your ability to get paid. In other words, flubbing up on your billing duties can cost your clinic big bucks—and no one wants to leave cold-hard cash sitting on the table …

  • What Makes Us Grateful: Thanksgiving Thoughts from Top PT Leaders Image

    articleNov 23, 2016 | 4 min. read

    What Makes Us Grateful: Thanksgiving Thoughts from Top PT Leaders

    Ah, Thanksgiving. We’re just hours away from that celebratory time of year when we turn our focus to family, food, and football. But while we’re all excited about getting elbow-deep in all the yummy Turkey Day delicacies (green bean casserole FTW!), let’s not forget about the true purpose of this annual tradition: giving thanks. In that spirit, we thought you might delight in some Thanksgiving reflections from a few of rehab therapy’s finest. Heidi Jannenga Co-founder and …

  • Are PTs, OTs, and SLPs Really Off the Hook for PQRS in 2017? Image

    articleNov 21, 2016 | 3 min. read

    Are PTs, OTs, and SLPs Really Off the Hook for PQRS in 2017?

    As we approach the end of the year, rehab therapists everywhere are (hopefully) busy squaring away all of their compliance plans—including those having to do with quality data reporting—for 2017 and beyond. And for the last several years, those plans have included provisions for successfully completing PQRS. This year, however, is a different story: Medicare released its Final Rule earlier this month, and amidst the 1,400-plus pages of pure gobbledygook, CMS indicated that PQRS is officially coming …

  • 4 MIPS and MACRA Must-Knows for PTs, OTs, and SLPs Image

    articleNov 17, 2016 | 7 min. read

    4 MIPS and MACRA Must-Knows for PTs, OTs, and SLPs

    The holiday season is right around the corner, and while this time of year is always ripe for celebration—and rightfully so—the elimination of PQRS doesn’t mean you should bust out the confetti and noisemakers just yet. Wait, therapists no longer have to report PQRS data to Medicare—and that’s a bad thing? While that stand-alone decision may give you all the holiday feels , it should also give you pause: the truth is that because rehab therapists are …

  • How to Bill for One-on-One Therapy Services Provided in a Group Treatment Setting Image

    articleNov 15, 2016 | 4 min. read

    How to Bill for One-on-One Therapy Services Provided in a Group Treatment Setting

    Humans are naturally social creatures. Being in groups gives us more confidence—and for patients seeking rehab therapy services, that can often lead to better outcomes. But, as a therapist, knowing when and how to bill for one-on-one services (a.k.a. individual therapy) in a group treatment setting can be tricky to say the least. Here are a few things to consider when treating multiple patients during the same timeframe: Billing for Individual Services In some ways, billing for …

  • Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap Image

    articleNov 7, 2016 | 4 min. read

    Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap

    Halloween and the whole pretend thing may be over, but follow me for a second: when a Medicare patient comes to you for treatment, it’s critical that you also play the roles of investigator and lawyer (though costumes are optional). Clearly documenting the therapy services you are providing during the current benefit period —without skimping on the details—can potentially save you from an audit. In fact, your documentation is like evidence in a court case . So, …

  • MAC Madness: When and How to Contact Your Medicare Contractor Image

    articleNov 4, 2016 | 4 min. read

    MAC Madness: When and How to Contact Your Medicare Contractor

    Medicare providers have a lot of challenges to contend with—and meeting those challenges can be tough. But, you don’t always have to go it alone, because while you can’t always count on CMS to provide clear guidance on how to comply with all the regulations that apply to you, you do have other resources at your disposal when you need answers—quick. Let’s talk about one such resource: your Medicare Administrative Contractor (MAC). Your Medicare Go-To Even if …

  • Why Issuing Blanket ABNs is a No-No Image

    articleOct 28, 2016 | 4 min. read

    Why Issuing Blanket ABNs is a No-No

    With Medicare routinely changing and tightening its rules on reimbursement, PTs may be worried about receiving payment in a timely, efficient manner. Fortunately, Advance Beneficiary Notices of Noncoverage (ABNs) help you cover all your financial bases, as they: put the onus on your Medicare patients to decide whether they would like to accept financial liability (i.e., pay out-of-pocket) for the therapy services you provide; and safeguard you when Medicare denies a claim. So, why not issue ABNs …

  • The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP Image

    articleOct 27, 2016 | 33 min. read

    The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP

    In October, we hosted a webinar dedicated to the most common Medicare misconceptions . We received a lot of questions from the audience—so many, in fact, that we’ve organized them all into one huge FAQ. Scroll through and check them out, or use the link bank below to skip to a particular section. The Therapy Cap ABNs Modifiers Supervision Prescriptions and Certifications Cash-Pay Rules and Regulations Re-Evaluations Everything Else   The Therapy Cap If a patient reaches …

  • Why Medicare-Enrolled PTs Can't Always Provide Treatment on a Cash-Pay Basis Image

    articleOct 27, 2016 | 3 min. read

    Why Medicare-Enrolled PTs Can't Always Provide Treatment on a Cash-Pay Basis

    Even if you feel comfortable with all things Medicare, chances are there’s a new rule in the works ( oh, looky here ) that could trip you up. Yes, the rules are always changing—and even the ones that have been in place for a while could get you stuck in a pickle (mmm, pickles). That’s especially true with the rules around providing treatment on a cash-pay basis , because your restrictions and obligations vary based on your …

  • Collaboration Compliance: The Ins and Outs of Team Therapy and Group Therapy Image

    articleOct 21, 2016 | 4 min. read

    Collaboration Compliance: The Ins and Outs of Team Therapy and Group Therapy

    Understanding the nuances of team therapy and group therapy —and how to bill for each—presents some challenges; based on the ol’ English language, you’d think these analogous terms are virtually the same. But, when it comes to rehab therapy billing, these two phrases are non-interchangeable—and treating them the same could put your practice at risk of claim denials or audits. So, how do know if you’re billing the right codes for treatment scenarios involving multiple patients—or multiple …

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